Fit notes issued by GP practices, England

Use the GP data hub to review the number of fit notes issued in general practice in England and fit note episodes by region and diagnosis.

What you can find out

This dashboard shows the volume of electronic fit notes and fit note episodes issued by GP practices in England.

Data is broken down by CCG, diagnosis (where known) and date of issue.

What the report can't tell you

The data does not cover all GP practices. Caution must be taken when making comparisons at regional or CCG level as data coverage must be taken into account.

Fit note data will provide information on the patterns of certification of fitness for work by GPs, rather than on the patterns of long-term sickness absence from employment. Fit notes are issued for either benefit or employment purposes but currently there is no means for a GP to record the purpose of issue, nor is it a requirement for the GP to establish the employment status of the patient for fit note purposes.

The data is not available at an individual level. Although fit note information is entered by the GP at an individual level, it is aggregated before extraction from the practice and presented in an anonymised form. Where necessary, additional measures such as small number suppression are used to ensure that no data is patient-identifiable

The age of the patient does not form part of the data extraction.The data not does provide a reliable picture of the working days lost to illness. This is because:

Only fit notes issued electronically in GP practices are included (hand-written fit notes, fit notes issued by secondary care or hospital doctors, medical certificates provided by private doctors and fit notes for patients who objected to having their data extracted are excluded).

Not all employers require their employees to provide a fit note.

An individual can be issued a fit note as 'may be fit for work' which would allow them to return to work following advice.

Not all fit notes are issued for employment purposes.

For longer absences, the fit note duration does not cover the initial 7 day period where most employers allow staff to self-certify.

any short term absences up to seven days will not be covered as a fit note is not required.

The number of fit notes issued in a given period does not relate to the number of individuals issued with a fit note in the same period. This is because an individual patient can have more than one fit note issued over the time period, either for the same episode of illness or for a different episode.

More information about fit notes

The Statement of Fitness for Work (the Med3 form or 'fit note') was introduced in April 2010 across England, Wales and Scotland. It enables doctors to give advice to their patients about the impact of their health condition on their fitness for work and is used to provide medical evidence for employers or to support a claim to health-related benefits through DWP.

A fit note is issued after the first seven days of sickness absence (when patients can self-certify) if the doctor assesses that the patient's health affects their fitness for work. The doctor can decide the patient is 'unfit for work' or 'may be fit for work subject to the following advice...', with accompanying notes on suggested adjustments or adaptations to the job role or workplace.